Rat study sug­gests Al­ler­gan's failed an­ti­de­pres­sant ra­pastinel may work as opi­oid ad­dic­tion treat­ment

Last month, when Al­ler­gan’s $AGN once-tout­ed pipeline star ra­pastinel crashed and burned a slate of piv­otal de­pres­sion stud­ies, it looked like the ex­per­i­men­tal mod­u­la­tor of the NM­DA re­cep­tor would be shroud­ed in a cloak of in­vis­i­bil­i­ty — but re­searchers may have found a way to res­cue the ex­per­i­men­tal drug by re­pur­pos­ing it as a treat­ment for opi­oid de­pen­dence.

Ju­lia Fer­rante

In the Unit­ed States, the cri­sis of opi­oid abuse, mis­use and over­dose — from pre­scrip­tion painkillers, hero­in, and syn­thet­ic opi­oids such as fen­tanyl — has reached epi­dem­ic pro­por­tions, caus­ing 130 deaths every day, ac­cord­ing to NIH es­ti­mates. Once in with­draw­al, ad­dicts are left to cope with a myr­i­ad of symp­toms in­clud­ing anx­i­ety, ag­i­ta­tion, sleep prob­lems, mus­cle aches, run­ny nose, sweat­ing, nau­sea, vom­it­ing, di­ar­rhea and opi­oid crav­ings.

In or­der to man­age these of­ten de­bil­i­tat­ing symp­toms, with­draw­al is man­aged by sub­sti­tu­tion with a less pow­er­ful opi­oid, fol­lowed by grad­ual re­duc­tion or tran­si­tion to main­te­nance ther­a­py with FDA-ap­proved med­ica­tion-as­sist­ed treat­ment (MAT) drugs such as methadone, buprenor­phine or nal­trex­one, which can have un­pleas­ant and some­times dan­ger­ous side ef­fects and of­ten must be used for months to avoid re­lapse. Al­though the process of ta­per­ing opi­oid con­sump­tion and us­ing MAT to treat opi­oid ad­dic­tion is stan­dard-of-care, it sus­tains the brain changes that re­sult in ad­dic­tion in the first place, which can lead to re­lapse be­fore treat­ment is com­plet­ed, ac­cord­ing to re­searchers who eval­u­at­ed the use of ra­pastinel in opi­oid de­pen­dence.

The tri­al in rats test­ed the use of ra­pastinel ver­sus ke­t­a­mine — a com­mon­ly-used cat tran­quil­iz­er and par­ty drug known as Spe­cial K or Kit Kat — which has been pro­posed as an al­ter­na­tive, non-opi­oid treat­ment for opi­oid with­draw­al, but it has the po­ten­tial for abuse, in­duces a trance-like state and can cause hal­lu­ci­na­tions. In fact, J&J’s $JNJ ke­t­a­mine-based de­pres­sion drug Spra­va­to has al­ready won FDA ap­proval. Ra­pastinel binds to the same re­cep­tor as ke­t­a­mine but at a dif­fer­ent site, where it con­fers a milder ef­fect.

Cyn­thia Kuhn

The sci­en­tists first in­duced opi­oid de­pen­dence in male and fe­male ado­les­cent (be­tween 28 and 30 days old) Sprague-Daw­ley rats by in­ject­ing them with mor­phine in in­creas­ing dos­es twice a day for five days. On day six, rats were in­ject­ed with nalox­one and with­draw­al signs were quan­ti­fied. The rats were then giv­en ei­ther ke­t­a­mine in­jec­tions twice dai­ly (n=12), ra­pastinel in­jec­tions every oth­er day (n=14), or saline in­jec­tions (n=24). On day nine, when the rats were giv­en nalox­one to mea­sure with­draw­al signs, ra­pastinel-treat­ed rats ex­hib­it­ed sig­nif­i­cant­ly few­er with­draw­al signs than those treat­ed with ke­t­a­mine.

The find­ings sug­gest that treat­ment with ra­pastinel in­duced safer with­draw­al, sans any se­ri­ous side ef­fects, dur­ing the crit­i­cal first days in the ef­fort to ab­stain from opi­oid use — and the sci­en­tists hy­poth­e­sized this would lead to a de­creased risk of opi­oid re­lapse.

“Ra­pastinel re­search for opi­oid de­pen­den­cy is cur­rent­ly on­ly be­ing done in ro­dents, but if the drug con­tin­ues to have suc­cess­ful tri­als, it may en­ter clin­i­cal tri­als for use in hu­mans,” said Ju­lia Fer­rante, an un­der­grad­u­ate at Vil­lano­va Uni­ver­si­ty who con­duct­ed the re­search with Cyn­thia Kuhn, pro­fes­sor of phar­ma­col­o­gy and can­cer bi­ol­o­gy at Duke Uni­ver­si­ty.

The re­searchers are look­ing to keep test­ing ra­pastinel to in­ves­ti­gate its ef­fect on the mol­e­c­u­lar lev­el and to check whether it can re­duce the risk of re­lapse. The drug has a long way to go be­fore it cross­es the fin­ish line, but if ap­proved it would like­ly be ad­min­is­tered in­tra­venous­ly, pos­si­bly in an out­pa­tient set­ting, Fer­rante added.

John Hood [file photo]

UP­DATE: Cel­gene and the sci­en­tist who cham­pi­oned fe­dra­tinib's rise from Sanofi's R&D grave­yard win FDA OK

Six years after Sanofi gave it up for dead, the FDA has approved the myelofibrosis drug fedratinib, now owned by Celgene.

The drug will be sold as Inrebic, and will soon land in the portfolio at Bristol-Myers Squibb, which is finalizing a deal to acquire Celgene.

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UP­DAT­ED: AveX­is sci­en­tif­ic founder was axed — and No­var­tis names a new CSO in wake of an ethics scan­dal

Now at the center of a storm of controversy over its decision to keep its knowledge of manipulated data hidden from regulators during an FDA review, Novartis CEO Vas Narasimhan has found a longtime veteran in the ranks to head the scientific work underway at AveXis, where the incident occurred. And the scientific founder has hit the exit.

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Ab­b­Vie gets its FDA OK for JAK in­hibitor upadac­i­tinib, but don’t look for this one to hit ex­ecs’ lofty ex­pec­ta­tions

Another big drug approval came through on Friday afternoon as the FDA OK’d AbbVie’s upadacitinib — an oral JAK1 inhibitor that is hitting the rheumatoid arthritis market with a black box warning of serious malignancies, infections and thrombosis reflecting fears associated with the class.

It will be sold as Rinvoq — at a wholesale price of $59,000 a year — and will likely soon face competition from a drug that AbbVie once controlled, and spurned. Reuters reports that a 4-week supply of Humira, by comparison, is $5,174, adding up to about $67,000 a year.

The top 10 fran­chise drugs in bio­phar­ma his­to­ry will earn a to­tal of $1.4T (tril­lion) by 2024 — what does that tell us?

Just in case you were looking for more evidence of just how important Amgen’s patent win on Enbrel is for the company and its investors, EvaluatePharma has come up with a forward-looking consensus estimate on what the list of top 10 drugs will look like in 2024.

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ICER blasts FDA, PTC and Sarep­ta for high prices on DMD drugs Em­flaza, Ex­ondys 51

ICER has some strong words for PTC, Sarepta and the FDA as the US drug price watchdog concludes that as currently priced, their respective new treatments for Duchenne muscular dystrophy are decidedly not cost-effective.

The final report — which cements the conclusions of a draft issued in May — incorporates the opinion of a panel of 17 experts ICER convened in a public meeting last month. It also based its analysis of Emflaza (deflazacort) and Exondys 51 (eteplirsen) on updated annual costs of $81,400 and over $1 million, respectively, after citing “incorrect” lower numbers in the initial calculations.

The key dates for KRAS watch­ers through the end of the year — the trail is nar­row and risks are ex­treme

There’s nothing quite like a big patent win when it comes to burnishing your prospects in the pipeline. And for Amgen, which seems to have rescued Enbrel for a run to 2029, the cheering section on Wall Street is now fixed on AMG 510 and a key rival.

And it didn’t take much data to do it. 

There was the first snapshot of a handful of patients, with a 50% response rate. Then came word that Amgen researchers are also tracking responses in different cancers, at least one in colorectal cancer and appendiceal too. 

Bain's Or­ly Mis­han joins Pfiz­er's neu­ro spin­out Cerev­el; On­colyt­ic virus biotech taps Sil­la­Jen ex­ec He­le­na Chaye as CEO

→ Bain Capital is deploying one of its top investors to Cerevel Therapeutics, steering a $350 million-plus neuro play carved out of Pfizer. Orly Mishan — a co-founder and principal of Bain’s life sciences unit — was involved in the partnership that birthed the biotech spinout in the first place. As Cerevel’s first chief business officer, she is tasked with corporate development, program management as well as technical operations. 

UP­DAT­ED: Sci­en­tist-CEO ac­cused of im­prop­er­ly us­ing con­fi­den­tial in­fo from uni­corn Alec­tor

The executive team at Alector $ALEC has a bone to pick with scientific co-founder Asa Abeliovich. Their latest quarterly rundown has this brief note buried inside:

On June 18, 2019, we initiated a confidential arbitration proceeding against Dr. Asa Abeliovich, our former consulting co-founder, related to alleged breaches of his consulting agreement and the improper use of our confidential information that he learned during the course of rendering services to us as our consulting Chief Scientific Officer/Chief Innovation Officer. We are in the early stage of this arbitration proceeding and are unable to assess or provide any assurances regarding its possible outcome.

There’s no explicit word in the filing on what kind of confidential info was involved, but the proceeding got started 2 days ahead of Abeliovich’s IPO.

Abeliovich, formerly a tenured associate professor at Columbia, is a top scientist in the field of neurodegeneration, which is where Alector is targeted. More recently, he’s also helped start up Prevail Therapeutics as the CEO, which raised $125 million in an IPO. And there he’s planning on working on new gene therapies that target genetically defined subpopulations of Parkinson’s disease. Followup programs target Gaucher disease, frontotemporal dementia and synucleinopathies.

But this time Abeliovich is the CEO rather than a founding scientist. And some of their pipeline overlaps with Alector’s.

Abeliovich and Prevail, though, aren’t taking this one lying down.

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Chi­na has be­come a CEO-lev­el pri­or­i­ty for multi­na­tion­al phar­ma­ceu­ti­cal com­pa­nies: the trend and the im­pli­ca­tions

After a “hot” period of rapid growth between 2009 and 2012, and a relatively “cooler” period of slower growth from 2013 to 2015, China has once again become a top-of-mind priority for the CEOs of most large, multinational pharmaceutical companies.

At the International Pharma Forum, hosted in March in Beijing by the R&D Based Pharmaceutical Association Committee (RDPAC) and the Pharmaceutical Research and Manufacturers of America (PhRMA), no fewer than seven CEOs of major multinational pharmaceutical firms participated, including GSK, Eli Lilly, LEO Pharma, Merck KGaA, Pfizer, Sanofi and UCB. A few days earlier, the CEOs of several other large multinationals attended the China Development Forum, an annual business forum hosted by the research arm of China’s State Council. It’s hard to imagine any other country, except the US, having such drawing power at CEO level.